[Empiric therapy with amiodarone in patients with chronic Chagas cardiomyopathy and sustained ventricular tachycardia].
OBJECTIVE
To evaluate the efficacy and safety of long-term empiric amiodarone therapy in patients with recurrent Sustained Ventricular Tachycardia (SVT) and Chronic Chagasic Myocarditis (CCM).


METHODS
Thirty-five patients with CCM and SVT, eighteen (51%) of them were refractory to other antiarrhythmic drugs. The Amiodarone loading dose was between 600 and 1200 mg/day, mean of 883 +/- 239 mg/day, from a period of one to four weeks. The maintenance dose was decreasing in the follow-up period, it fell down to 356 +/- 125 mg/day at the end of six to 80 (mean = 27 +/- 20) months. Cumulative, event-free interval curves were generated by the Kaplan-Meier method. Clinical variables were compared with the use of the Student t-test or by means of chi-square tests.


RESULTS
The probability to suppress SVT was, 0.62 in 12 months, 0.56 in 24 months and 0.44 in 36 months, with regular use of amiodarone. The probability to the occurrence of sudden death was 0.0 in 12 months, 0.04 in 24 months and 0.11 in 36 months. The stratification of risk to clinical recurrence was significative to the left ventricular disfunction. All patients with functional class III or IV and LV ejection fraction less than 30% at radioisotopic ventriculography had clinical recurrence, while just 30% of patients with functional class I and II have got it (p less than 0.05). Fifteen (42.8%) patients had side effects. The treatment was discontinued in four patients (11.5%).


CONCLUSIONS
The empiric treatment with amiodarone apparently was effective in patients with SVT and CCM and functional class I and II. Patients with functional class III and IV did not get benefits from the treatment. In these cases other therapy must be pointed out.
Scanavacca
M I
MI
Instituto do Coração do Hospital das Clínicas, FMUSP.
Sosa
E A
EA
Lee
J H
JH
Bellotti
G
G
Pileggi
F
F
D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000009:adverse effects / Q000627:therapeutic use*; D002598:Chagas Cardiomyopathy / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D002908:Chronic Disease; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D012008:Recurrence; D013610:Tachycardia / Q000188:drug therapy* / Q000209:etiology
D000638:Amiodarone
Terapêutica empírica com amiodarona em portadores de miocardiopatia chagásica crônica e taquicardia ventricular sustentada.